CAJ | 학술논문

目的观察长春瑞滨联合顺铂(NP方案)在乳腺癌二线新辅助化疗中的价值.方法以2008年6月至2011年12月,在北京大学第一医院乳腺疾病中心住院接受蒽环类联合紫杉类化疗临床疗效评价为稳定,改行NP方案新辅助化疗的乳腺癌患者为研究对象,选择动态增强MRI并参照RECIST1.1标准进行临床评价,实施手术后参照Miller-Payne病理评价标准进行组织病理学疗效评价,并观察其不良反应.结果共33例患者入组,其中临床疗效评价完全缓解(CR)0例,部分缓解(PR) 16例(48.5％),稳定(SD) 17例(51.5％),进展(PD)0例,总有效率(CR+ PR)48.5％.组织病理学评价G1 6例(18.2％),G2 6例(18.2％),G3 10例(30.3％),G49例(27.2％),G5 2例(6.1％),有效率(G3+ G4 +G5)63.6％.不良反应主要为骨髓抑制,胃肠道反应及肝功能损害,无不能耐受化疗退出病例,无化疗相关死亡及重症感染.结论 NP方案作为乳腺癌二线新辅助化疗方案疗效显著,患者耐受性良好,可作为二线新辅助化疗备选方案.
목적 관찰장춘서빈연합순박(NP방안)재유선암이선신보조화료중적개치.방법 이2008년6월지2011년12월,재북경대학제일의원유선질병중심주원접수은배류연합자삼류화료림상료효평개위은정,개행NP방안신보조화료적유선암환자위연구대상,선택동태증강MRI병삼조RECIST1.1표준진행림상평개,실시수술후삼조Miller-Payne병리평개표준진행조직병이학료효평개,병관찰기불량반응.결과 공33례환자입조,기중림상료효평개완전완해(CR)0례,부분완해(PR) 16례(48.5％),은정(SD) 17례(51.5％),진전(PD)0례,총유효솔(CR+ PR)48.5％.조직병이학평개G1 6례(18.2％),G2 6례(18.2％),G3 10례(30.3％),G49례(27.2％),G5 2례(6.1％),유효솔(G3+ G4 +G5)63.6％.불량반응주요위골수억제,위장도반응급간공능손해,무불능내수화료퇴출병례,무화료상관사망급중증감염.결론 NP방안작위유선암이선신보조화료방안료효현저,환자내수성량호,가작위이선신보조화료비선방안.
Objective To study the value of a combination of vinorelbine and cisplatin (NP) as second-line neoadjuvant chemotherapy regimen for primary breast cancer.Methods Primary breast cancer patients on neoadjuvant chemotherapy and non-responsive to anthracyclines plus taxans received the NP regimen.The clinical objective response was evaluated with dynamic contrast-enhanced magnetic resonance imaging (MRI) according to RECIST 1.1 before operation.The pathological response was evaluated by the Miller-Payne grading system.And the toxicities were observed and evaluated according to National Cancer Institute-Common Terminology Criteria Version 3.0 (NCI-CTC v3.0).Results A total of 33 breast cancer patients were examined.The outcomes were complete remission (CR,n =0,0％),partial remission (PR,n =16,48.5％),stable disease (n =17,51.5％) and progressive disease (n =0,0％).The clinical responsive rate (CR + PR) rate was 48.5％.The pathological response rates were G1 (n =6,18.2％),G2 (n=6,18.2％),G3 (n=10,30.3％),G4 (n=9,27.2％) and G5 (n=2,6.1％).And the pathological response (G3 + G4 + G5) was found in 21 cases (63.6％).The most common toxicities included neutropenia and nausea/vomiting.No serious toxicities were observed.Conclusion As a welltolerated and effective regimen,NP regimen may be recommended as an option of second-line neoadjuvant chemotherapy regimen for primary breast cancer.